Endometriosis UK
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Pregnant with endo - section or natural?

Hello, looking for some advice please....

I have stage 4 endo with a lot of scar tissue and adhesions. I've had 3 laps in the past and last one was over a year ago.

I'm now 24 weeks pregnant after having IVF earlier this year.

I'm being consultant led at the hospital and have been told I won't be able to use a birthing pool or go past my due date. I have had ongoing endo pain throughout the pregnancy and find any kind of internal examination very painful. Also having bad pelvic girdle pain and have a tiny pelvis.

I'm hoping to discuss the birthing plan at my next hospital appointment so just looking for recommendations etc so I have plenty info before I go. I obviously want to go for the best option for the baby, but am concerned about the long term side effects of section / natural and how it will affect my endo. Thanks in advance xx

5 Replies

The only reason why you should consider a caesarian is if your pelvis cannot accommodate your child. I'm sure this is not the case. More than likely the reason you can't go over is due to the fact you had ivf so don't worry. Endo and spd make pregnancy really painful and hard going but do not affect your baby, just you. You can explore pain relief options. I had dihydrocodeine and they gave me tramadol I think it was in the cupboard (never took).

I would opt for a natural birth as the long term ramifications of a csec for someone with endo aren't to be taken lightly. You can do it :) and if you can't you can still have a csec. I've done it twice. Second pregnancy was way easier if that's any consolation. But the first one hurt so bad. Both my babies are perfect so keep going xxx


Hi and thanks for taking the time to reply and words of encouragement. x


Hi - there are no rules that apply to this, it depends entirely on the individual. Assuming the baby is in a normal position it will depend first on whether your pelvis and cervix dilation will allow a natural birth which would apply to anyone , with or without endo. But endo can complicate the issue depending on where it is. As you have stage 4 (presumably untreated as yet) you are likely to have Pouch of Douglas endo which means that your bowel would be stuck to the back of your vagina and cervix. This causes the cervix to be fixed and depending on the extent of the adhesions the ability of the cervix to dilate can be affected. Also the uterus is usually tilted in an unnatural position. During pregnancy endo pains most usually go away as the oestrogen that feeds it takes a back seat and another oestrogen takes over, estriol. But as you are continuing to have pain this will be due to the pulling of adhesions as your uterus has swelled.

Your consultant is clearly aware of the possible complications and as you are being consultant lead everything will be closely monitored and all precautions taken to ensure the best outcome for you and your baby. If during labour you are advised that you must have a Caesarian you must follow his/her advice to avoid the baby becoming distressed because this will mean that it is physically impossible for it to pass through the birth canal. When I had my son I hadn't been diagnosed and was in labour for 15 hours with my cervix not expanding any more than the 6 cms it was right at the beginning before going to hospital. I was just in general maternity and finally had to have a very rushed emergency c section. Subsequently many years later I was found to have endo just in my pouch of douglas.

Everything may go perfectly with a natural birth, but follow your instincts at the time and the specialist's advice because all that matters is that you have a healthy baby and if this means a c section it will all be worth it.

Once you are a proud mum I should consider referral to an endo centre at some time in the future to have your endo excised, especially if you want another baby. x


Hello and thanks for your reply. My endo is on pouch of Douglas and ligaments so I guess that's why I'm still have pain. Thank you for all the info, hoping to discuss at length with my consultant when I finally see him. We're having a wee boy too 😊


I hope it all goes well. Mine was a beautiful boy too. Was just my only one and he is the light of my life. Now 20 and at vet school. x


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